mental health

Yes I’ve been inactive on here for a while: work has taken over more and more of my time and energy. Things came to a head this Monday however. I took an overdose of lorazepam.

The following day I wrote this, as my attempt to iron out my thoughts. Put simply, I don’t understand why I did it. I don’t understand what’s happening to me.

Earlier my GP asked if I was depressed. Honestly I wasn’t. I most definitely did not want to return to work, so that’s something to stab at. But as my mother pointed out, I’ve been coming home from work for weeks, stating how I’m enjoying bookselling again. And I have been. However none of this changes the fact that there’s the parallel dimension – this alternate universe within my head saturated with white noise and hyper-thought and erratic compulsions.

I’ve been drinking more and more. Self-medication is the prevalent term I believe. The sense of release, the comfort; but also the trangression. Acting normal, functioning while under the influence. What’s fascinating/scary is that I can go off piste stone cold.

I call it the “Cold Flame”. Inside of me there’s this energy; something wondrous and beautiful and beneficial. But its most definitely a dangerous gift – sometimes my mind works every angle, turning things over and over and over and over. Simulating things which have happened, haven’t happened, could happen, can’t.

My eyes glow. Flames emanate from my hands. I’ll look over my shoulder and converse with my thoughts rather than merely think them. We are an army a million as many as your own (though there is sometimes sedition in the ranks). That “crazy” guy rambling to himself on the street? Hello. There’s a little more subtlety in my discourse, but if the lift door opens at the right time I’ll be there running my nails down the walls; clutching my head and waiting out the latest cacophony.

You may hear “We” instead of “I.”

I register people’s eye movements, lip twitches, the way they shuffle their feet or move their arms. The thoughts, concerns, opinions and emotions of others flood torrentially into my mind. I’m not deluded or arrogant enough to claim telepathy but hey, just because you’re not a bat, doesn’t mean you can’t hang upside down.

Some realisations wait in the wings; quietly murmuring their lines until some mysterious stage hand points towards the lights. An aroused audience of one bristles as our player stumbles across the boards. Flowering at last, a bloom of gestures and revelatory dialogue which can tranquilize or incinerate with a pyroclastic fervour.

Its been quite some time since I’ve posted on this site. Sat down and tried to fulfil the promise and purpose of this little domain which I long ago intended to discuss the aspects of, and issues around, “my illness.” A nebulous term which draws its authority from a peculiar and potentially dangerous branch of pseudo-science. Considering bipolarity a disorder has never helped me. Lithium reigned me in, though I cannot say that there isn’t an alternative method for equalising my moods. To my great shame a vein of cowardice – or worse apathy – makes it unlikely that I’ll ever seek one out.

Epilepsy has given me a metric by which to measure the pathology of my psyche. Epilepsy is quantifiable. EEGs can demonstrate wiring faults as effectively as any halfway competent electrician. The MRI sketches poured over and waved triumphantly above the heads of psychopharmacologists appear to suffer from an a certain object impermanence. Traction subsides, and the diagnoses and treatment plans of every mental health professional I’ve ever encountered comes from defaulting to a sort of conventional wisdom; perhaps characterised by instincts which would be familiar to Witchfinders General.

The last 36 words aren’t necessarily dismissive. Perception is everything after all. If you treat bipolarity as an illness – if that helps keep you as healthy and happy as can be – then that is the reality as it applies to you. My experiences (within and without mental “illness”) have instilled a Ballardian appreciation of unreality and dominant fictions of the world around me. The recalibration of my mind and moods comes from repeat attempts to calculate and reconcile the contradictions and inverted logic of the suspicious and deliciously perverted “real”.

From here on in, my thoughts and attempts to make my way through this world, will hopefully hinge upon a more conscious appreciation of these dim repressions. The human body is a mechanical wonder driven by powerful and adaptive OSs. To drive the mechanism onwards, to maintain its inward integrity whilst engaging with competitive systems, requires flexibility and mutation. Consciousness, the imagination, the psyche: all crucial constructs which can neither function nor exist within fixated boundaries.

The query has become: how do I function? The query has become: why do I function? The query has become: how and why don’t we function the same?

I won’t call it an epiphany. Lightbulbs can’t take this long to come on. Call it a lingering, teasing subconscious knowing.

Ask me about my earliest memories and all I can summon up are impressions. Emotions, colours, oblique images of sunlight and green leaves and running running running. Imagination is a good word. In my head. Always in my mind.

My earliest cohesive memory is of the day my father left home. Chasing after him as he charged through the front door. Mum and dad had spent what felt like days in their room. I walked in at one point and was immediately turned out again. Memories are unreliable at the best of times. This is what I recall.

Divorcing couples is mundane. The significance of this event has less to do with the details and the drama. For me, it was the moment I had to confront a world outside of myself.

I worshipped my father. He was funny, kind, knowledgable, creative. Over the years I resented my mother because she dealt in what’s practical, what’s necessary; while it was all magic with him. Over time I matured and became wise to the wonder in her too, as well as appreciating the sacrifices and true value of everything she had done for me and my brother. I can’t say I ever hated my father. I resented what followed in his wake.

Calling it “The Damage” may be a little extreme. My comic strip mentality wants to call it an “activation event” – a shock preceding a critical change. Looking back I consider that my whole life has been about the fissure between my outer and inner worlds: again a fairly mundane struggle, but more overt in people “like us”.

The other night I was casually regarding my toes. Picturing what my feet would look like with certain ones cut off. Considering the permutations and how my walking would be affected. I haven’t cut myself in nearly ten years but I think about it every day. When I wake up and before I go to sleep. My right arm, which took the brunt of all the Red back in the day, feels heavy. Sometimes like lead; and I just leave it hanging it at my side as I walk

Is there any worth in writing a suicide note, even if you have no cause or intention to follow up on its promise? Should it be something everyone does – setting out the reasons you want or need it to stop, in the hope that you’re heading off trouble ahead of time? Sign offs have never appealed to me, because you can never cover everything and honestly why would you leave that behind? Something tangible, crafted in your misery, tainting the fingertips of those you’ve left behind.

I won’t call it an epiphany, because deep down I’ve always known. I’m waiting for it to stop. That it’ll end “before my time” seems inevitable to me. I cannot cross the divide – I’m still that little boy caught between two worlds, and the bleed is too much to take on sometimes. I have to be this way because all bases must be covered.

News about the loss of Robin Williams has opened a deep well of mourning for and gratitude to a remarkable performer. His diversity and talent won him plaudits and affection the world over. I’ve often found that people have a particular Robin Williams they love – for some he’s Mork from Ork, my sister-in-law adores Mrs Doubtfire. For me he will always be Genie.

His family have rightly asked for their privacy to be respected at this difficult time. A statement referring to his recent struggles with depression remains the wellspring of speculation about what has happened. Further details will emerge, the news cycle will endure a little longer and many debates will be had.

One thought came to my mind when I heard the news: wealth and fame offer no guarantees against misery and torment. A commonly held notion amongst those with mental health challenges is that their lot would improve if they could afford private treatment and regular sessions with an independent therapist. Access to medication would no longer carry any financial penalties.

The logic holds, overall, but a story like this is important because it reminds us there are no quick fixes, and no one cookie-cutter strategies can be expected to work. We don’t know how Williams coped with his condition, and personally I feel it a little ghoulish to speculate in this forum.

All I will say is that we must be mindful of the fact that sometimes we can only fight so hard. But the fight is worth it, and their are so many pathways and approaches to pursue. And we cannot forget that sharing any suicide’s fate is never guaranteed either.

No two people can inhabit the same world. Beliefs, opinions and prejudices distort reality the way mass warps the path of light. Circumstance can mean that, though we might agree that chair is red; it’s green to someone with a specific form of colour blindness. They may concede that an absence or dysfunction of long wavelength cones in the eye causes deuteranopia; but ultimately to them, the chair is green.

I’m no philosopher and I’m certainly no scientist. I simply cannot escape the significance of an analogy like this. The chair is green in the subjective. It is only red by consensus. Let’s find an alternate dimension where deutans are in the majority – now what are you sitting on?

Colour Blind Awareness states that, globally, 1 in 12 men and 1 in 200 women live with some form of this condition. 8% of my gender live their lives with dissonant chroma. My cousin ranks amongst them, as did my maternal grandfather. That we’re not inundated with stories of cars piling through traffic lights because of misread signals is deeply encouraging. A mutation which could dramatically impact upon the day-to-day of a great many people has become well managed and almost completely anonymous.

In 2005 researchers from the University of Cambridge and the University of Newcastle upon Tyne used multidimensional scaling (MDS) to explore ‘the colour dimension that is private to the deuteranomalous observer.’ The study emphasised an important correlation between “colour normal” and deuteranomalous observers – that they are both formally trichromatic (requiring three primary lights to ‘match all possible spectral power distributions.’) Despite the differences in colour perception, there is no inherent deficit or dysfunction:

MDS studies of anomalous trichromats have, however, always had a phenotypic bias: stimuli have been selected to be discriminable for the normal observer and the anomalous space has typically been found to be contracted compared to the normal. Such results reinforce the categorization of anomalous trichromats as ‘color deficient’, but this represents the viewpoint of the majority phenotype.

Interestingly the study refers to a potential evolutionary advantage gifted to anomalous/alternative trichromats. Research suggests that the efficacy of camouflage is threatened by ATs, particularly when it resembles natural foliage or terrain. Food sources and predators may become easier to clock; practical applications expressed in some primate species. Genetic drift may have allowed such individuals to make an advantageous contribution to our earliest, socialised ancestors. Hunter/gatherer parties including, though not wholly comprising ATs may have been ahead of the curve.

As expressions of the worth and wonder of re-thinking how we determine what is and isn’t a disability – as well as opening eyes to the potential benefits of any “anomaly” – discussions of colour blindness offer a delightful elegance and simplicity. Clearly, on the spectrum of what we consider disabilities, disorders, diseases…et cetera, not all animals are going to be equal. Issues will never be (ahem) black and white.

All I would say is consider the alternatives whenever you consider or encounter anyone with anomalous expressions or characteristics. Maybe you’ll find yourself ahead of the curve too.

I had a psych appointment at 12.30. Having crash landed into the NHS Mental Health Trust 13 years ago, today came the novelty of having to produce my passport, a recent bank statement and a fully completed “Pre-Attendance Form.” To discuss these documents at the start of a health assessment, then having to wait as they were photocopied at the end.

Immigration and public services are hot button issues right now, perhaps in ways they haven’t been since the 1980s. As Chris Addison noted, we accidentally elected a Conservative government four years; and the rise of UKIP has ratcheted up every tension. Still, I’ve been in the goddamn system long enough to prove my entitlement status. And, crucially, personally, I don’t consider the PAF in the spirit of socialised medicine.

NHS funding principally comes from taxation. I am a tax payer. That illegal immigrants may be using the service has never pissed on my pancakes. Individual health benefits everyone. If you have to drive without a license, its better you don’t fall into a diabetic coma at an intersection. I’ll concede that our borders need policing, that immigration must be handled responsibly, but I can’t help but shudder when I read how information from the PAF can be passed to the UK Border Agency ‘…if it is deemed necessary by the trust.’ Patient information. I had to answer questions about the number of residents in my house. Number of hours I work a week. 13 years. The first time in 13 goddamn years.

Please note non presentation of the above documentation on the first appointment could delay your assessment and subsequent treatment.

I’ve contacted these people because I want to keep my options open, given my recent spikes in hypomania and bouts of whip-spin paranoia. I am relatively stable right now, so a delay wouldn’t do much harm. But I have to compare my current state of mind to Me at 17. Late teens, consistent self-injury, potent depression culminating in a dramatic suicide attempt that – while not taking my life – could have left me paralysed. My 17 year old self couldn’t wait. It was my mother stressing this that actually got me into the clinic. The trust wanted to release me back into the wild.

Everything about the NHS, particularly the mental health sector, just feels paradoxical and contrary and kind of frustrated. Even Dr Sri; the very paradigm of a dedicated, intelligent, sympathetic professional bemoaned this. That he couldn’t do more for his patients. I refuse to accept that the NHS, or socialised medicine of any stripe, is inherently doomed to fail. Any ill fate comes from incompetence and mis-management, hackneyed bureaucracy and financial derangement. Manipulation and greed.

A recent case centres on a Basildon man forced to pay £2000 per week to treat his brain tumours. ‘Avastin is not licensed by the manufacturer for treatment of brain cancers in England’, an NHS teeth-piece explained. As noted in the article, cosmetic surgery and gastric bands are readily available on the NHS. I don’t really object to these, but clearly we’re forced to come down on either side of this issue. That force is economic.

The devil is always in the unnerving machinations when it comes to Big Pharma. In the excellent Cracked.com article 5 Terrible Secrets Big Drug Companies Don’t Want You to Know, writer Andrew Munro recalls the curious history of Sarafem. Marketed by drug firm Eli Lilly as a treatment for premenstrual dysphoric disorder (PMDD), Sarafem was a breakthrough in the fight against an ‘…exaggerated form of PMT.’ The typical symptoms of PMDD (fatigue, emotional instability, anxiety, disinterest in daily activities and difficulty concentrating) may be familiar to those receiving treatment for depression, which is handy, considering Sarafem is Prozac by another name. And a pretty colour palette.

Munro: ‘…by releasing a new drug identical to Prozac, Eli Lilly managed to extend their patent by a few years, allowing the price of Prozac to remain nice and high.’ This is what we have to contend with, as “service users”. The administrative locust horde, frenzied by persistent interference from mandarins, transient politicians and “business managers”; whilst being undermined by low-quoting contractors and manipulated by opportunist corporations who’s spreadsheets can determine who lives and who dies. Now we can add crossing guards to the roll call.

I fear for the NHS. For all my criticisms, for all my ideological stances against the dominant psychiatric models, I have to accept that it has helped keep me alive. Given the sense of disquiet and violation I feel after today’s meeting, I fear for others like me, especially those younger than me, who now have another swamp of uncertainty to wade through. We have an increasing Eastern European presence in this part of the world. Whole new generations who may need access to mental health services. Young people, older people who’s misery, fear, torment, doubt, self-loathing, anger – the whole bloody rainbow of psychiatric crises – may now be compounded by a fear of incriminating themselves or those they love.